Objectives The aim of this study is to give an overview of the treatment available for the patients with Hepatitis C Virus (HCV) through the segmentation of HCV patients in Italy. Methods The study was carried out in 9 hepatology centers, treating HCV patients in 9 Italian Regions. The structures selected constitute a representative sample of the Italian scenario, being Centers of Excellence in HCV management in northern, southern, and center of Italy (representing about 24% of the 2.000 patients treated with first generation Triple Therapy in Italy according to AIFA Data). The patients’ distribution has been investigated in terms of fibrosis stage (F0 to F4), therapy type (Triple, TT, or Double therapy, DT) and treatment status (naive or experienced patients). Results Data (collected from structures and Workshop of Pharmacoeconomics in Hepatology) show that HCV patients are more concentrated in the two fibrosis stage extremes: 43% in F0-F1 Range, 23% in F2,32% in F3-F4 Range and 2% unclassified. Data about drug administration demonstrate that, at national level, patients are equally distributed between therapy type (56% TT and 44% DT) and treatment status (49% naive and 51% experienced). On the contrary, at Regional level many differences were found in all of the three parameters examined. In the structure investigated in Campania, for example, 72% of patients receive TT and 76% are experienced, while in Lazio 72% of patients receive DT and 72% are naive. Furthermore, considering the fibrosis stage, the 46% of patients treated in a center operating in Bari is in the range F3-F4, whilst in the center in Milan the 56% of the HCV patients treated is in range F0-F1. Conclusions The study demonstrate that, concerning the treatment of HCV, there are significant differences among the hepatology centers, both in terms of patients’ health status and therapy pathways.